Thank you. Before I call Dr. Evan Harris to open the debate, I should inform the Chamber that he has requested that Mr. Speaker exercise his discretion to waive the House’s sub judice rule to enable reference to be made to the case of Miss Debbie Purdy, which is currently under appeal. The Speaker is willing to exercise his discretion to enable reference to be made to the Purdy case for the purpose of discussing the principles that it raises. Members should not, however, discuss the details of the case.
A large number of hon. Members are present, some of whom have written in. I shall try to strike a balance between the parties and between points of view. If colleagues seek to catch my eye and have not already written in, they might like to send me a note briefly explaining their point of view.
Thank you for that statement, Mr. Bayley. It is a pleasure to have you in the Chair.
Many hon. Members wish to speak. I intend to take 10 minutes, but if there are interventions, which I am willing to take, that will lengthen my time a little. However, I shall try to curtail my remarks. This is the first time in 10 years that the issue has been debated, but I do not intend to cover everything that could be said on it. The subject raises strong feelings on both sides of the House, across parties, in the media and among the public, and it is only right that Parliament should debate it and be seen to debate it.
It is right that the legislature should be seen to keep such things under consideration, and I hope that there can be a review—more active consideration than mere debate—and that the House will be allowed to come to a view on the matter at some point, as it is unlikely to be easily subject to manifesto commitments or party Whips.
I want to make it clear that although I have been an elected member of the British Medical Association medical ethics committee for many years, I am not speaking on its behalf. I am grateful to Dignity in Dying for its briefing material.
No doubt the hon. Gentleman would care to clarify that the majority of doctors were, when last asked, opposed to the legalisation of assisted suicide. All the medical royal colleges and the BMA have declared their opposition to it after extensive consultation with their members. He has rightly declared his connections, but will he acknowledge that he is probably in the minority of clinicians in the views that he holds?
I have never been of the view that what doctors say goes, and I do not believe that I am in a minority. If the question is asked fairly and properly, it is far from clear that there is not majority support in the medical profession for giving people autonomy, with safeguards, of course, over end-of-life decisions. The benign conspiracy in which many doctors sometimes participate for paternalistic reasons is, in this case, far worse than making clear arrangements, with safeguards, to enable patients to have more autonomy.
This morning, we heard about the very sad case of a 13-year-old girl who says that she wishes to die with dignity at home. There is a life-preserving operation with a good chance of success that she could have, and, as far as we know, she is not in pain or suffering. Doctors say that if she had that treatment she would not be liable to die very soon. Even in that difficult case and even though she is not strictly terminally ill or in unbearable pain and suffering, she has been allowed autonomy over that decision. She is entitled to do that at the age of 13, and the situation is even more clear-cut for adults. They can refuse treatment when not terminally ill, when not in pain and suffering and when that refusal will cause their death.
If someone wishes to be actively helped to die, they cannot get that help in this country under the law, even when there is no doubt about their capacity. That is true even when it has been checked that there has been no coercion, when they are terminally ill and when they are suffering. They might not be suffering from pain, with modern palliative care, but they might still be suffering unbearably, in their view. The difference between the treatment of those two cases, when the outcome is the same, is so extreme that it cannot be justified.
I am grateful to my neighbour from Oxford for giving way. I am sure that we can all understand the sensitivity of the case to which he has referred, but does he not accept, as I think most of the public do, that there is an important difference between not intervening artificially to prolong life and actively intervening to shorten it?
Of course I accept that there is a difference, but it is not so great that autonomy should be taken away completely in one situation and respected absolutely in the other. The end result is the same, and the wish is the same; it is only the activity or passivity that is different. It is not right that we should defend forcing someone to be kept alive against their will simply on the basis that assisted dying involves an act—their own act, in most cases—rather than simple refusal. I do recognise that there is a difference though.
On the current law, the Suicide Act dates from 1961, and is in need of revision. Assisting someone to die is punishable by a maximum penalty of 14 years’ imprisonment, but such a punishment would be inappropriate in the sort of case that we are discussing. We all know of examples of people who are seeking help to die, and that is different from assisted suicide. The hon. Member for Bridgend (Mrs. Moon), who is present, knows that we are not talking about assisted suicide. Assisted dying is for people who want to live, not for people who want to die, as with assisted suicide. I have no difficulty with the current law criminalising assisted suicide when people are suicidal and are helped through websites or indirectly. I hope that she will have the chance to acknowledge that point later.
In the case of Debbie Purdy, although the court recognised the argument that the current situation was unsatisfactory, it specified that it was for Parliament to change the position. Parliament should examine the 1961 Act. It is not the case that the law ain’t broke, so we shouldn’t fix it. We cannot say that, and I shall give examples of the negative consequences when terminally ill people are forced to look for alternatives to exercise control over the manner and timing of their death when they feel that their suffering has become unbearable.
Figures suggest that 16 British citizens travel to Dignitas each year. The Home Office has identified about four cases of so-called mercy killings each year, which is probably a small fraction of the real number, as they often never reach the courts. Each year, a number of terminally ill people resort in desperation to violent and often botched suicides, and a number of people find that they have to refuse food and water to exercise control over their time and manner of death. They use their ability to refuse treatment because the fairest and most humane way of exercising control is not available to them. More than 900 people a year receive assistance in dying from their doctor, on their explicit request. They are forced to get illegal assistance to die, and the consequences of that can be severe not only on the manner of their dying but on those who seek to help them.
If the hon. Gentleman wishes to quibble about the point, I am speaking in the context of what he is discussing. Will he answer my substantive question? How many people who assisted that which he wants them to be able to assist without consequence suffered a term of imprisonment, either actual or suspended?
But I do not know whether the hon. Gentleman is happy that people are doing that and not being imprisoned, or whether he thinks that it is bad that people are not being punished for what is strictly an offence. Not knowing whether they are liable to be prosecuted and imprisoned is a traumatic experience for many, particularly the recently bereaved.
I can give the Chamber the opportunity to hear the answer to the question asked by the hon. Member for New Forest, East (Dr. Lewis), which is zero.
The Minister must be asked the same question, then. Is it a good thing that people are apparently breaking the law but not being imprisoned, and perhaps not even prosecuted? Either way, we ought to have a law that says what it means and means what it says, rather than making people feel that they have to take a chance. Some think that they cannot take that chance, so they are unable to give or receive assistance.
There is not a choice between palliative care and assisted dying. Everyone recognises that palliative care is an important part of end-of-life care, and the suggestions for legislation on assisted dying have included palliative care. However, it is a form of treatment, and at some point a person is entitled to say that they are fully palliated as far as medical and nursing care can provide for, and that they do not wish to have any further palliation as an alternative to a dignified death. It is not for us to impose on them our view that they must be satisfied with the palliative care that they get. In jurisdictions where there is assisted dying, there has been an increase in the provision of palliative care, and rightly so. In Oregon there is no perceived conflict between the two.
I shall give some examples of the difficulties that people face in knowing what will happen to them if they assist someone with death. As we know, Dignitas helps people with incurable illnesses to die, and it regularly features in the British media. We understand that 650 British citizens are members of Dignitas, and more than 100 have travelled to Switzerland to have an assisted death since October 2002. I wish to mention the case of Reg Crew, who had motor neurone disease. His wife Win Crew and their daughter Jan Healey accompanied him to Dignitas when he died in January 2003. His wife Win has written:
“Although I am a Roman Catholic, like many others in my position, when Reg said he wanted medical assistance to die, to avoid a long and painful death, I felt this was the right thing to do. I agreed with him that the disease should not rob him of the ability to choose the manner of his inevitable death…For several months after my return, I had the threat of legal action hanging over me but what alternative was there?”
The problem with the current state of the law for people in that situation is that they fear legal consequences for their loved ones on return to the UK. That is cruel. A lack of legal certainty about prosecuting those who accompany loved ones to Dignitas leads some terminally ill people to travel to Switzerland all by themselves, and as a consequence to go earlier than they would have liked. It forces people to make that decision while they are still able to make it themselves and do not need assistance. They are forced to die in a foreign country, away from familiar surroundings and in some cases without their loved ones.
The second example is mercy killing. Under current law, anyone who ends the life of another can be convicted of murder and receive a life sentence, even if the act is a compassionate response to a dying person’s request for help to die—a so-called mercy killing. Despite the risk of a murder conviction, a number of people who resort to mercy killing regard it as the final act of love towards a loved one who is dying and requests help to die. Home Office records show that in the past 15 years, a total of 57 suspects in homicide cases could be described as being involved in mercy killings. Again, that probably represents a small fraction of the true number.
The impact of that is, again, very negative. There is obviously a risk of imprisonment, long drawn-out trials and public labelling. People who have committed an act of mercy killing often also suffer long-term effects on their mental health, which can lead to self-harm or even suicide. A Home Office report states that of the 57 suspects of the act of mercy killing, 21 have committed suicide.
With no clear policy in place, people may claim to have committed a mercy killing or assisted a suicide for compassionate reasons, when in fact their motives were more sinister or selfish. We do not have a law that provides safeguards. Mercy killing is clearly not the answer, nor is the status quo, so we have to recognise what is happening and consider what can be done to avoid the all-round negative consequences.
Violent or botched suicides are another consequence of the current law. People take the act into their own hands and attempt suicide, which can lead to long drawn-out and painful deaths. It is impossible to calculate the number of such cases, but examples are known. My final example is Sue, who has said about her terminally ill father’s attempt to commit suicide:
“My father had prostate cancer. At some point there was nothing more doctors could do. My Dad sadly experienced how the laws in this country operate. He threw himself down the stairs in an attempt to kill himself. It didn’t work, but the doctor left him there as long as he could, waiting to see if he might die. This is how the law forces doctors to abandon their patients. My father was left at the bottom of the stairs for two hours with a cut on his head. Eventually he died a week later at home.”
As a consequence of the law, people are sometimes forced to die a lonely death in the absence of their loved ones, out of fear of the legal consequences for anyone they ask to be present at the time of their death.
As it is illegal for anyone to help another person to die, some people choose to commit suicide while they are still able to do so. Again, that may mean that they die earlier than they would wish. Authorities in Oregon are aware of 94 terminally ill people who were prevented from committing violent suicide because the option of assisted dying was available to them, and 50 of them went on to die a natural death. I do not have time to go into the case of people who refuse food and water, but again it means a more protracted death than the painless one that is available through assisted dying.
The hon. Gentleman is helping the House and the country by talking about death in a way that is not embarrassed or afraid. Can he give the number of people in the Netherlands who have had death brought on early by request, and compare it with the overall suicide rate?
I think those figures are available and if the hon. Gentleman will allow me, I will try to come back to that later, because I do not have them to hand.
Finally, I want to say a word about doctors helping their patients to die and about the review of the murder laws. We know that there are occurrences of involuntary euthanasia, where doctors help patients to die without their wish, and of voluntary euthanasia, which is the patient’s wish. I shall quote from a research paper by C. Seale, “National survey of end-of-life decisions made by UK medical practitioners”, in Palliative Medicine 2006, volume 20. On pages 3 to 10 it shows that
“of all the deaths in the UK in 2004, 0.16 per cent. were cases of doctors ending life following an explicit request from the patient”.
That means, in broad figures, that 936 deaths were a consequence of patients receiving assistance in dying from their doctor on their request. Such assistance is given outside any legal framework and without any safeguards. We know that assisted dying is taking place at the moment and it would be far better, as has been done in other jurisdictions, to put it on a legal footing, with whatever safeguards the House feels are appropriate. If people are worried about the protection of the vulnerable—I understand that concern—the answer is to have the safeguards in place. It is not a question of the principle of providing for autonomy.
I want to raise with the Minister the review of the law of murder. The Law Commission has recommended that the Government undertake a public consultation on whether the law should recognise either a defence or partial defence of mercy killing and if so, to what extent. So far, the Ministry of Justice and the Government have not taken up that recommendation. It would be appropriate for them to do so, given that it was made by the Law Commission and given that the Government have pursued other approaches in the review of the law of murder, including a new definition of diminished responsibility.
The new definition—that a person must have a recognised medical condition that substantially impairs their ability to make a rational judgment about the criminal act— seeks to achieve something separate in respect of attacks in domestic situations by people claiming provocation. I understand that and I am not arguing against it, but even that definition will have an impact on a partial defence being available in the case of mercy killing. It is not a case of doing nothing; the Government are already doing something that will have an impact, so it must be right for there to be an holistic approach.
Although there is more that I could say, including on the figures that have been requested, I invite the Minister to recognise in her summing up that there are many views in Parliament and that the Government and any political party will find it difficult to put the issue in a manifesto. I hope, therefore, that she will at least be open to the idea that we need to have a review, and that Parliament must, from time to time, since 1961, have the opportunity to debate this matter in a careful, clear and informed way.
Order. A great number of hon. Members want to speak. I have not quite done the calculations, but we are talking about three or four-minute speeches, if everybody is to be called. Am I right in understanding that the Liberal Democrats do not have a Front-Bench spokesman present?
I congratulate the hon. Member for Oxford, West and Abingdon (Dr. Harris) on securing the debate. It is about time that the issue was debated. Clearly, there are strong feelings on both sides, and it would be silly to pretend otherwise. I am much in favour of a change in the law along the lines put forward in Lord Joffe’s Bill, which was debated in the House of Lords some two years ago. Although it was defeated, it reflected to a large degree the sort of measure that I would like, with all the necessary safeguards. It was tightly drawn, as any such measure must be.
I raised the matter in the House of Commons at business questions on 30 October, and I asked for the opportunity to have a debate. Interestingly, the Leader of the House replied:
“The criminal offence of assisting somebody’s suicide is unique as it is the only part of the criminal law where it is an offence to assist the commission of something that is itself not an offence.”—[Official Report, 30 October 2008; Vol. 481, c. 1039.]
That was an interesting interpretation, and no doubt the Minister will echo it when she responds.
Somehow, the impression tends to be given by opponents of the measure that those who want to see a change in the law want to encourage the terminally ill to end their lives by such means. Nothing could be further from the truth. Both sides in this controversy rightly take the same line on the need for the best palliative care to be available to the terminally ill.
The same applies to hospices. In my borough of Walsall, we have campaigned for more than a quarter of a century to have a hospice, and I am glad to say that at long last there is a reasonable chance that we will have one within two years. On those sorts of measure—on doing everything possible for the terminally ill—there is no difference between the two sides whatsoever. Again, I repeat that the idea that those of us who want a change in the law want to encourage people to die could not be further from the truth, and that should be emphasised.
As the hon. Gentleman said, we are faced with a small number of people—it will always be a small number—who take the position, as their health worsens, that they simply want to end their lives. Of course, if they were in a position to commit suicide, that would be quite legal; if they attempted suicide and did not succeed, they would not be prosecuted, because of the 1961 Act. Those people are either unable to commit suicide, because of their medical condition, or simply do not wish to do so. If I were terminally ill and I decided that I wanted my life to come to an end, I would not wish to commit suicide, perhaps for lack of courage or confidence that I could do it.
The question arises, which is the crux of the debate: should the law permit those who are in such a condition that they want to end their lives to do so in this country, without travelling abroad? That is the nub of the issue, and it is not going to go away. The controversy will continue, but I believe that, in time, although I do not know when—quite likely not in my lifetime—there will be a change in the law.
Last week a national newspaper carried a piece about a different person to the one mentioned by the hon. Gentleman. Her husband had been diagnosed with terminal cancer three years ago. He received treatment—I am sure that he received the best treatment available—but there came a stage, as she wrote in the article, when he decided that he simply did not want to continue to live. That was his wish. Some hon. Members who are strong opponents of what I am suggesting would no doubt take the view that he should not have that right, but he nevertheless believed that he had the right to control his own life and to decide that it should come to an end. He knew that it was not possible to do so in the United Kingdom, but he also knew that he could go to Switzerland, where the means would be provided for him to do so. Although there have been no prosecutions, there is always a possibility of prosecution. Despite that legal risk, his wife and adult children decided that they would accompany him. They were insistent that he should not go on his own, and they went to Switzerland. He was filmed confirming that he was acting on his own free will, before he was given a drug in liquid form, and the wife and the children held his hand as he died.
I accept that there needs to be the strictest safeguards against abuse. I would not wish to be a party to any change that did not have such safeguards. Hence, the measure in Lord Joffe’s Bill would be limited and apply only to the terminally ill, where two independent doctors had examined the person. Provision would include a palliative care specialist, who would explain all the available alternatives. At every stage, the person would have the right to change his mind.
There is no question of such a measure leading to large-scale abuse. I do not deny that abuse could occur—it would be wrong to say that it would be impossible—but I believe that the kind of measure that I have described, which was defeated in the House of Lords, would provide the widest possible provisions for dealing with abuse and all the other difficulties that obviously cause us concern.
The hon. Gentleman commented on the situation in Oregon, where the position is much along the lines that I have been advocating. Its assisted dying Act, the Death with Dignity Act, has been in existence since 1994. It is interesting that the number of people who die in hospice care—I emphasise “hospice care”—in that state has doubled since the Act came into operation. Therefore, the idea that providing facilities such as those that I have been recommending for the terminally ill means that there would be less care or that more people would decide to take their lives has been shown to be absolutely false in the one state in the United States where such facilities exist.
I note that during the presidential, state and Senate elections—whatever elections took place last week—there were several resolutions on the ballot paper. In Washington, a large majority voted in favour of having the same provision as in Oregon.
That reminds me of the House of Commons and the House of Lords. I am not surprised, as such things take time. Various reforms, changes and measures that affect private behaviour and things such as the abolition of the death sentence and so on all took time and a great deal of campaigning. Obviously, my hon. Friend, whose view is different from mine, is encouraged by what he just said. I am discouraged by it, but it is a matter of debate.
I hope that the debate will continue. Just as people were given a right to decide under the Suicide Act 1961 that they could take their lives, I strongly believe that people who are terminally ill should be able to decide that they want to end their life, despite all the care and facilities that are available, and be able to do so without travelling abroad. The sooner the law is changed, the better.
Unlike the hon. Member for Oxford, West and Abingdon (Dr. Harris), I believe that the empire of the law should have some limits. It may be perverse for a legislator to say this, but I do not think that a change in the law would be the right way forward in this regard, although I very much understand the suffering involved in the individual cases to which he and the hon. Member for Walsall, North (Mr. Winnick) referred in their speeches.
When my father was dying 18 years ago, I had a role, as his next of kin, to work with a long-standing family doctor to ensure that he had enough morphine—he was terminally ill with cancer—to ward off pain. To an extent, his life might have gone on a few days or weeks longer than it would have otherwise. That seemed to be the common-sense approach to the situation. This may seem rather hypocritical, but I think that, at times, we should perhaps turn a blind eye to what are often desperately difficult circumstances.
We must recognise that, as a compensation and blame culture becomes more prevalent around the world and in this country, medical professionals in particular will become increasingly reluctant to do the right thing if there are laws in place that may be seen to provide safeguards but simply regulate their lives more strongly.
I have fears about an assisted dying, or euthanasia, regime putting pressure on elderly people who do not have an immediately life-threatening condition. In essence, the right to die could morph into a duty to die.
I believe that I can refer to the recent high-profile case of the 23-year-old rugby player, Daniel James, who was taken by his parents to Switzerland. It was a dreadful case. One of the most disquieting aspects was that, when the story came into the public domain some months after his death in Switzerland, his parents referred to his having been a second-class citizen, given the injuries that he had sustained. Those injuries were serious and may not have come through even under the Joffe safeguards. They massively affected quality of life but were not life-threatening. It was envisaged that Daniel James could well have lived for some decades to come. What was worrying was the notion of his in any way having a second-class life or being a second-class citizen. Saying that some lives are more valuable than others is dangerous.
Absolutely. In many ways, the case demonstrates some of the difficulties that we face in trying to frame a law that will cover all the cases that we would wish to cover, while ensuring that individuals have the right to die or to go through an assisted-dying process.
What worried me most about the case was the lack of common sense shown by the police. The reality of the situation—this may sound rather hypocritical—is that the police must take a common-sense approach. As someone who believes in a higher being—unlike the hon. Member for Oxford, West and Abingdon—I think that perhaps the judge in these ethical and moral matters should not be on this planet but elsewhere.
I was encouraged by the Minister’s comment that there had been zero prosecutions in the nearly 50 years since the Suicide Act 1961. [Hon. Members: “Imprisonment.”] No imprisonment, although there may have been prosecution and some investigation.
We need to take a much more common-sense approach to these desperately difficult ethical matters. I am glad that we are having this debate. I know that many hon. Members wish to speak, and I hope that as many people as possible will be able to put their viewpoints across in the course of the debate. We will obviously be interested to hear some of the Government’s thinking about how this element of the law should be changed, if at all.
First, I declare that I am chairman of the national Care Not Killing alliance and a patron of Alert. Those two organisations oppose the introduction of assisted suicide and voluntary or involuntary euthanasia to the law of this land. CNK promotes palliative care and tries to educate the general public about the arguments in this difficult policy area.
There is no doubt that the Voluntary Euthanasia Society—I still call it that but will come to its new title in a minute—has been behind many of the attempts in this country over many years to change the law. It has increased its lobbying recently. It was behind Lord Joffe’s Bills and has been involved in many of the high-profile cases that have ended up at Dignitas in Switzerland. It has used the media, particularly television, to put some hard cases to the public. I was on television last week after an emotional appeal by a Bristol lady, Kelly Taylor. It is difficult for someone with an opposing view to appear on that medium after an emotional appeal to end a person’s life has been made, but I believe that bad law would be the result if the general public, and this place in particular, were to listen to all the hard cases. We have to consider the whole area.
I am sorry but I cannot, as I have limited time.
Over five years, Lord Joffe made three attempts in the House of Lords to change the legislation in this policy area. Each time, he softened his approach. Have hon. Members noticed? Let me mention what he has said in a Select Committee in the House of Lords:
“We are starting off, this is a first stage....I believe that this Bill initially should be limited, although I would prefer it to be of much wider application, but it is a new field and I think we should be cautious...But I can assure you that I would prefer that the law did apply to patients who were younger and who were not terminally ill but who were suffering unbearably, and if there was a move to insert this into the Bill I would support it.”
So his real intention is to get a Bill in to open the door and then later, perhaps, he or some other person in either the House of Commons or the House of Lords would try to amend the law. We are at a critical stage. Once the law is amended, the door is open to all kinds of exploitation in future.
I have a huge amount of respect for the hon. Gentleman and I know that he has considered these matters for a long time. Does he not accept that it is for Parliament to decide the law? Arguing that we should not make a change in the law because Parliament might later change it, forwards or backwards, is no sort of argument; it is not even a slippery slope argument, because Parliament is there to decide. I am sure that he understands that Parliament has made rules on embryo research, including on 14 days, which he supported, even though it could go to 28 days if an hon. Member proposed it and Parliament agreed. But we still do the right thing a step at a time.
I think that my further remarks will answer that question.
The Voluntary Euthanasia Society started with terminally ill, mainly elderly, people suffering, initially, from cancer. It did not win the argument using such cases, so it then looked at long-term cases: people suffering from muscular dystrophy, multiple sclerosis and motor neurone disease. A number of cases have been paraded before us in the media, some of which have been mentioned today. All those cases are tragic. The Voluntary Euthanasia Society has even changed its name to Dignity in Dying and is also campaigning for improved palliative care, with a sting in the tail, of course, because it has supported, and has now successfully achieved, getting living wills on to the statute book. There is no doubt in my mind about what is happening. We will have a soft approach until the legislation is changed and then the very people who change that legislation will harden their stance later.
To answer the hon. Member for Oxford, West and Abingdon (Dr. Harris), I am pleased that a High Court judge said recently that the place to change the law is not in the courts, where the Voluntary Euthanasia Society has been taking its cases; the place to change the law is here, in the two Houses of Parliament. This is where we must have the debate and we must have a much more extended debate than we have time for this morning.
In 2005, Lord Goldsmith, when he was Attorney-General, said to the House of Lords Select Committee on Assisted Dying for the Terminally Ill Bill:
“it would be inappropriate…for him”—
the Director of Public Prosecutions—
“to issue a policy the effect of which was to say that ‘I, the Director of Public Prosecutions, have decided to suspend or not to apply part of the law which Parliament has put in place and has not removed’”.
So the judiciary is clear on this: parliamentarians must change the law—
I am sorry but I will not give way. The law cannot be changed significantly in the courts of law.
A number of hon. Members have mentioned various states and countries, including the Netherlands, the state of Oregon and Washington state, which has recently changed the law. The significant thing about Oregon is that, according to recent research published in the British Medical Journal, one in six Oregonians who have taken lethal drugs provided by their doctors were actually suffering from treatable depression, which the doctors had failed to diagnose. There is a danger that some people will want to go beyond terminal illness and serious long-term conditions and go to younger people and those seriously suffering from mental illness as well. Baroness Warnock said in a recent article in The Times:
“If you’re demented, you’re wasting people’s lives, your family’s lives, and you’re wasting the resources of the NHS.”
What a statement for a peer of the realm to make! Let me remind hon. Members that some of the 700,000 Alzheimer’s patients in this country would follow the course proposed by hon. Members if Baroness Warnock and her supporters had their way.
I am sorry but I will not give way. We have limited time.
The majority of doctors are opposed to physician-assisted suicide, as is the British Medical Association and all the royal medical colleges. In 2005, the House of Lords Select Committee recorded the view of the General Medical Council:
“A change in the law to allow”—
“would have profound consequences for the role and responsibilities of doctors and their relationships with patients. Acting with the primary intention to hasten a patient’s death would be difficult to reconcile with the medical ethical principles of beneficence and non-maleficence.”
I agree. In the words of Lord Carlile of Berriew,
“The slippery slope is no fiction; it is already well-polished.”
There are few of us who are not afraid of death, especially the uncertainty that is associated with it. We are all anxious not to become a burden on others and none of us would wish to suffer pain over a prolonged period. That is what organisations such as Dignity in Dying—I still prefer to call it the Voluntary Euthanasia Society—play on. The alternative is to ensure that people have dignity in dying and that their physical, spiritual and emotional requirements are met. I welcome the introduction by the Government of the recent end-of-life care strategy, which has many good things in it. Hopefully, dignity in dying will become much more prevalent when that strategy is practised across the country in future.
I do not want physician-assisted suicide to become a treatment option. I remind hon. Members what Hippocrates said in 400 BC:
“I will give no deadly medicine to anyone if asked, nor suggest any such counsel.”
How a society treats its dying patients is a litmus test for that society.
It is a pleasure to follow the hon. Member for Bolton, South-East (Dr. Iddon) for reasons that I shall explain. I claim responsibility for encouraging the Voluntary Euthanasia Society to change its name precisely because the allegations in respect of compulsory euthanasia were used quite neatly by opponents to muddle up in the public mind, and in the argument, what it stood for, which was voluntary euthanasia, and that is quite a different matter.
Following the arguments produced by the hon. Gentleman, I commend Lord Joffe and Baroness Warnock for their honesty. There are two sides in this debate, one of which, having watched how the arguments have been put forward, has been commendably straightforward about what it is seeking to achieve in tackling issues that many of us find profoundly difficult.
The hon. Gentleman made it clear that each time Lord Joffe introduced measures, they were increasingly restricted to try to test the views of the other place. Lord Joffe did that because every time we deal with the fundamental principle of whether competent adults should be able to judge whether to end their lives if they are terminally ill, that proposition is overwhelmingly supported by the public. I understand that, when this matter was tested most recently, 85 per cent. of the public agreed with that basic proposition, and they do so because, like me, they see that it is only reasonable that people should have some autonomy at the end of their lives in circumstances where they have almost lost total control. If people have witnessed relatives dying in such circumstances, with total lack of dignity, they will understand that the change of name from the Voluntary Euthanasia Society is wholly appropriate.
Given the limited time, I shall address two particular points. My hon. Friend the Member for Cities of London and Westminster (Mr. Field) made a case for the “grey area” and for Parliament doing nothing. I am afraid to say that that argument can no longer be made. In the latest case, the judges have made it clear that it is time for Parliament to take up its responsibilities. I was concerned by the alacrity with which the Minister leapt to her feet to confirm for my hon. Friend the Member for New Forest, East (Dr. Lewis) that there have been no cases of imprisonment for assisted suicides. There have been prosecutions; people have been left on bail for murder for months and have then had to go through the judicial process. We are failing people such as the family of Debbie Purdy. They are in a position of doubt because we, as Members of Parliament, are not prepared to take up our responsibilities and make the law clear.
However, the issue is not just about those who are involved in assisting people to commit suicide who would not otherwise be able to do so in circumstances in which a terminally ill person is competent and wants to bring their life to an end; it is about providing the comfort of the knowledge that a terminally ill person will potentially have control at the end of their life over circumstances that they cannot predict. That is the greatest and most striking benefit from the change in the law in the state of Oregon, where 17 per cent. of people who are dying take the opportunity to discuss the possibility of ending their life in circumstances over which they have some control with their family. That simple proposition is overwhelmingly supported by the public and would bring comfort to an increasing proportion of our population who are now dying from diseases in a more drawn-out, longer, undignified way than previous generations. We, as Members of Parliament, have a responsibility to hold a debate and bring this matter to a conclusion. We must bring our laws up to date so that they operate in the interest of those people.
At the moment, we are obviating our responsibility and that is why I profoundly disagree with my hon. Friend the Member for Cities of London and Westminster. The grey area in which we are placing people leaves them in uncertainty and doubt, and we are not doing them any service at all. Medical professionals are now in a position in which they know that it is in the interests of their patient to administer the lethal morphine dose. However, that is cloaked by the law of dual effect, and they administer pain relief in the absolute knowledge that their patient will die. In many circumstances, the one thing they are unable to do is to establish the wishes of their patient because as soon as they enter into that discussion, they place themselves in peril of prosecution because we have failed to make the law clear. It is time for us to address that.
Like my hon. Friend the Member for Bolton, South-East (Dr. Iddon), I declare an interest: I am the chair of the all-party group on compassion in dying, and so, obviously, I have a specific and opposing view to him. I should like to make the view of the all-party group clear to hon. Members, because there is a great deal of misunderstanding about the views of Members who support the right to a dignified death.
Let us be clear that the law as it stands places an absolute ban on assisting another person to die. Assisting a suicide is an offence under the Suicide Act 1961—the law has not changed—and it is punishable by a possible 14 years’ imprisonment. The law is out of step with public opinion and the morals and values of today. In the recent ruling in the case of Miss Debbie Purdy—I am delighted to see she is with us today; she is a powerful advocate for the issues surrounding assisted dying—the judges acknowledged that the offence of assisted suicide is widely drawn.
I take that on board entirely, Mr. Bayley. Indeed, the judges ruled that only Parliament can change legislation—a point that I am sure we would all readily accept.
Some opponents of a change in the law on assisted dying argue that the law is not broken so we should not attempt to fix it. However, much evidence shows that, despite those claims, the status quo has many negative consequences. The hon. Member for Oxford, West and Abingdon (Dr. Harris) said that the status quo forces terminally ill people to look for alternatives, to exercise control over the manner and timing of their death when they feel that their suffering has become unbearable. That status quo has a terrible cost. We have already heard that, on average, 16 British citizens travel to Dignitas every year. The Home Office has identified that there are four cases of mercy killing each year, but I suspect that that represents only a small fraction of the real number of cases. Of course, such cases often never reach the courts.
Sadly, each year, a number of terminally ill people resort to what are often violent and botched suicides. A number of people refuse food and water, to exercise control over the time and manner of their death. In addition, every year more than 900 people explicitly request that they receive assistance in dying from their doctor. The consequences for those who help can be dreadful, and many terminally ill people are driven to desperate measures, such as violent suicide or starvation. They are unable or unwilling to find someone to help them, because they know that that would involve breaking the law.
Those figures demonstrate that the status quo has an extremely negative impact on a sizeable proportion of terminally ill people. I should like to make it clear that Dignity in Dying campaigns for all terminally ill people to have access to excellent top-class palliative care services, regardless of age, disease, geographical location or any other factor.
[Mr Eric Martlew in the Chair]
Of course, we all know that access to excellent palliative care is not always available. We also know that, for some people, good-quality palliative care cannot address their concerns about losing autonomy, control and dignity at the end of their lives. That is far from being a failure of palliative care. This is person-centred issue and, most frequently, at the heart of a request to die is a concern over a loss of autonomy and a desire for control.
The House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill recognised that there is a group of patients whose demand for medically assisted dying will not be deflected by any circumstance—certainly, not by more and better palliative care. The National Council for Palliative Care, the British Medical Association and Macmillan Cancer Support have all acknowledged that to be the case. Dignity in Dying believes that mentally competent terminally ill adults should be allowed the option—it is an option, because it is a matter of personal choice—of an assisted death within strictly legal safeguards. That would bring an end to the many negative consequences of the status quo for terminally ill people and their loved ones.
As we have heard, there are a number of ways in which individuals will take matters into their own hands—for example, Dignitas deaths, mercy killings, violent and unfortunately botched suicides, people refusing food and water and, in some cases, doctors helping their patients to die. The Swiss organisation Dignitas helps people with incurable illnesses to die and regularly features in the British media. In fact, more than 650 British people are members of Dignitas and, since October 2002, more than 100 British citizens have travelled to Switzerland to have an assisted death. That is an average of 16 citizens a year who go to Dignitas. Those people have travelled with the help of their loved ones, and they fear terribly what the legal consequences will be for their loved ones when they return to the UK.
The lack of legal certainty in respect of prosecution of people who accompany their loved ones leads some terminally ill people to travel to Switzerland alone and often—this is a very important point—much earlier than they would otherwise have wanted to do. People are forced to die in a foreign country, away from familiar surroundings and, in some cases, without their loved ones—without their family.
Mercy killings are slightly different. Under the current law, anyone who ends the life of another can be convicted of murder and receive a life sentence, even if the act is a compassionate response to a dying person’s request for help to die. Despite the risk of being convicted of murder, a number of people resort to mercy killing, and they often regard that as a final act of love towards a person—perhaps someone to whom they have been married for 50 or 60 years—who is suffering and has requested help to die.
Home Office records show a total of 57 suspected cases of homicide from 1990-01 to 2004-05 that could be described as mercy killings. I am sure that that is only a fraction of the real number, which can never be discovered. The current situation has incredibly negative effects.
I take on board that point, Mr. Martlew. I shall make just a couple of final points. The Law Commission has recommended a review of the way in which mercy killing is treated under the law, but the Government and the Ministry of Justice have not established such a review. In a written answer to me on 24 April, my hon. Friend the Minister said that the Government had no plans to do that, despite the fact that changes proposed by the Ministry of Justice to the law of murder could result in genuine mercy killings resulting in life sentences for murder. Such harsh treatment is unfair and goes against public feeling. I understand why the Government are making the proposed changes, but the effect could be that the benign sentencing that we have come to expect or to know in relation to genuine mercy killings is replaced by long custodial sentences. The whole area is murky, and I ask the Minister to adhere to the Law Commission’s recommendation for a consultation on mercy killing, which would be in everyone’s best interest.
In view of the fact that the hon. Member for Calder Valley (Chris McCafferty) took more than twice as long as the guidance from the Chair advised, I shall be exceedingly brief. I believe that the title Dignity in Dying would be far more appropriate for the hospice movement than for the former Voluntary Euthanasia Society.
I believe that my hon. Friend the Member for Cities of London and Westminster (Mr. Field) was absolutely right when he said that one has to apply common sense in these terribly delicate and sensitive areas. Legislating for situations as extreme as those with which we are concerned today is not the best way to apply common sense. The law and common sense are often poles apart. I believe that the hon. Member for Bolton, South-East (Dr. Iddon) put his finger on the nub of the problem when he said that hard cases make bad law.
My own sole contribution to the debate will be to pick on a single word that has been used by the apologists for voluntary euthanasia—safeguards. They say that, of course, appropriate safeguards must be in place. One cannot, in practical terms, put safeguards in place. One cannot safeguard a vulnerable elderly person from being pressed in private to tell the doctors that he or she wants his or her life to be ended prematurely, and one cannot have a safeguard against a selfless vulnerable person, even without pressure being applied by anyone else, feeling that it is their obligation to ask for euthanasia in order not to be a burden on others. Of course, as the hon. Member for Walsall, North (Mr. Winnick) said, there are relatively few tragedies in the present situation. Let us not substitute heavy-handed legislation to make a much larger number of abuses the consequence of ill considered interference by the state.
This is not the first time that I have debated euthanasia with my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris). I congratulate him on obtaining the debate. We have debated the issue before, certainly at the Liberal Democrat party conference in Southport—my constituency—in 2004. Then, the party backed assisted dying in principle, subject to important and very detailed safeguards, and called for a royal commission. Subsequently, there have been accusations of backsliding from one MEP in the north-west, but that none the less stands as the current party policy.
I lost that debate. I argued that there should not be a party policy, but my hon. Friend, through his persuasiveness, was able to convince the party otherwise. I must make it clear that our positions have not changed since: we stand on opposite sides of the fence. I feel that it is my destiny in this place to follow my hon. Friend, frustrating his legal innovations. As he is a chairman of the National Secular Society, I am reminded of the first MP who identified himself as an atheist in this place, Charles Bradlaugh, who was followed round by a stupider brother called Henry Bradlaugh. He used to appear at many gatherings at which he spoke in a messianic way about atheism and shouted at the back. I will not do that, because this is a very difficult and emotive issue, which is not helped by demonising or stereotyping proponents and opponents as either knaves or fools. There is clear moral intent and careful thought on both sides.
Clearly, important background views colour and run right through the debate. I acknowledge in the context of the debate that some see life as a gift that should be endured, or enjoyed, and some see it as an amazingly fortuitous random event that should be no more unpleasant than it has to be. For the purpose of the debate, we can park or bracket off the different faith positions and concentrate on a rational analysis of the inherent difficulties of assisted-dying legislation. I shall offer my personal analysis.
Assisted dying is a more inclusive, broader term than assisted suicide, with which it is conceptually confounded—it has been in the debate. It is clearly different from palliative care of the dying, suicide or a patient’s right to refuse treatment. Assisted dying proposals in all nations are designed to authorise and legitimate help given with the positive and primary aim of ending life swiftly—not generally, but subject to specific conditions. The grounds are invariably much the same. Either the individual believes something about their condition or the state believes something about their condition—that it is unbearable, hopeless, profoundly undignified or unnecessary or, as has been cited many times in the debate, lacking in autonomy.
Nearly all the proposals that we see these days insist that the individual must believe something and the state must do so, too. If just the state had a view of the individual’s condition, it would be involuntary euthanasia. If it was left entirely to the individual to judge their need of state euthanasia, we would have assisted suicide for depressives and the like. Both of those are unacceptable, so the only currently mooted proposals involve an individual regarding their life as intolerable, worthless, unbearable or lacking in human dignity and the state endorsing that choice. Their view on their condition is thought to need state, medical or social sanction. Most current proposals and most current laws—whether in Oregon, Holland or wherever—reflect that. An individual states a view of their predicament, and some authority agrees that that is rational. Grounds are stated by the individual.
The hon. Gentleman has put together quite a cogent argument, but something that he has not addressed and that has not been addressed at any time during the debate is that totally unregulated area that has entered modern life—the internet. On the internet, there is access to information about dying and how to take one’s life. There is no regulation of that and there is also—
I agree, but that is probably outwith the remit of the debate. I am simply making the point that there is a generic quality to every proposal that we see. Grounds are stated by an individual, and those grounds are then agreed by the state. Let us consider the recent case of Daniel James, who was not dying in the ordinary sense. In many cases, his choice was presented in the media as the right choice. It was agreed that his life was unbearable, a burden and so on. However, I have the same concerns as the hon. Member for Cities of London and Westminster (Mr. Field). I received an e-mail from a constituent of mine, and I will read a small section of it. My constituent, Dr. Sue Garner-Jones, wrote:
“I am writing to ask that you please say something about the hysteria surrounding the “bravery” of the late Daniel James and his family. I am seriously concerned that this might have a severely detrimental effect on anyone who lives with disability or cares for someone in this situation, especially as Mr. and Mrs. James are referring to his life as a tetraplegic as “second class”… I am a tetraplegic, as you may know, and have been for 30 years since a car accident paralysed me at 19... Many times I have felt despair, as most of us do, so of course I respect and understand this man’s decision and am not judging him: I have neither the wish nor right to do so. However, to call this action “brave”, “courageous” and “selfless” implies that those of us who battle on are “cowardly” and “selfish”, which is unfair and untrue… Please speak out as there should be one voice for those of us who turned a “tragedy” into almost a “triumph” and despite the temptation to give up went on. Society must not return to thinking of the disabled as literally “invalid.”
I thank my hon. Friend for giving way. He is my friend in the real world, not only in terms of the jargon that we use in discussions. However, I fundamentally disagree with him on this matter, and I am surprised that, as Front-Bench spokesman for the Liberal Democrats, he is attacking our party policy. Surely, if he votes with his conscience against assisted dying, he must accept that he is denying the consciences of other people, such as Daniel James, Christopher Pailthorpe, Debbie Purdy and Diane Pretty—
I am finishing, Mr. Martlew. My key point is that whatever their condition, some people will choose to react in one way and some in another. That applies right down to motor neurone disease. Last year, I had an intern whose father had motor neurone disease and appeared before Lord Joffe’s committee. The father died during the time that the intern was with me.
In deciding to authorise assisted dying, the state must take a view on the reasonableness of one action or another, and take the consequences. We can get out of that conclusion only if the state can unequivocally identify those conditions that individuals ought not willingly to have to bear. That cannot be done satisfactorily and with clarity without having a secular state with clear, immutable values. There is no evidence that the state has those values nor expectation that it will have or that other states will be able to do so. Over time and between countries, there will be marked differences on this matter.
My conclusion—this is my personal analysis—is that any argument presented must confront the accusation that we will be replacing the clear, albeit discretionary, law that we have now with a discretionary but fundamentally unclear law. We must answer that point.
I will endeavour to cover the four corners of the debate as best I can in the short time available. First, we must realise that the question is not whether the law is clear. It is. The question is whether it is the right law and, if it is not right, how we should change it.
Section 2(1) of the Suicide Act 1961 states:
“A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years.”
That could not be clearer. The one thing that criminal law must be, whether in the Suicide Act or any other aspect, is certain as to its meaning and effect. It is in respect of the effect of the legislation that certainty is beginning to leave us. It is not for me to say today where that certainty should be recovered—in a new law or in the strict implementation of the current law, or somewhere in between.
I congratulate the hon. Member for Oxford, West and Abingdon (Dr. Harris) on bringing this subject to our attention. The topic is difficult to grasp and sometimes embarrassing to talk about. However, as parliamentarians, we must think about it from time to time. The Suicide Act was passed in 1961—nearly 50 years ago. No statute is necessarily apt for all time, and it may be that Parliament will, following the advice of the divisional court and the recent judgment of Lord Justice Scott Baker, reach a conclusion that may last us for another 50 years. We should not shrink from having that debate. I congratulate the hon. Gentleman on at least beginning that process, even if we do not reach a conclusion today.
The question we need to have answered is: what should the law be? The answer cannot come from the courts, albeit that the courts are—this may surprise the professional politicians among us—reasonably good at reflecting public opinion and expressing it in a coherent and rational way. In the recent case, Lord Justice Scott Baker emphasised that the case was not about whether it should continue to be a criminal offence in this country to help another person, whatever the circumstances, to take their own life: that was a matter for Parliament and not the courts. Nor was it about whether someone could obtain, in advance, immunity from prosecution for helping another person to travel to another country where assisted suicide is lawful for the purpose of an assisted suicide. That question had already been decided in the negative by the Appellate Committee of the House of Lords in the case of Diane Pretty.
We should not mislead ourselves by referring to that recent case or any earlier case. We as a Parliament must decide on a matter of public policy about where the law should be directed. As I said a moment ago, we must grapple with that decision with some vigour. Given the increasing number of cases and the publicity that this sort of law attracts, we cannot simply let matters lie. We cannot avoid the debate. I am not suggesting that the law necessarily needs to be changed, but we must be clear what we are about. If that requires us to think for ourselves, so much the better.
The hon. Gentleman has made it clear, on other occasions if not this one, that in the past, most Members of Parliament would have considered life to be God-given and that it was not for human beings to step into the shoes of the Almighty to terminate it. However, society and the way that Members of Parliament think and have been brought up has changed considerably, not only in the past 50 years, but in the past 150 years. It is still shocking that in the five years prior to 1958, 3,000 people were convicted not of assisted suicide, but of the crime of attempted suicide. Of those, nearly 200 were sent to prison. Within most of our lifetimes, people have been sent to prison for attempting to kill themselves. Those figures shock us, but today we tend to think of those who attempt suicide as people who need help and pity, not condemnation and punishment.
I suspect that we are beginning to think differently about those who want to end their own life for their own private reasons. It is not for me to provide an answer or rewrite the law, but it is important that the process of thinking begin. We should not be embarrassed to take outside advice or to allow ideas to be tested—some to destruction, some to the fruition of greater thoughts. Before I rose to speak, eight Members brought their personal, political and philosophical experiences to the debate. I have been impressed by, among other things, the absolute conviction that doing nothing and not having the debate is no longer an option. We must apply our minds both outside and inside Parliament to ensure that we create a set of laws and a regime that will be apt for the next 50 years, if not for all time.
You will readily appreciate, Mr. Martlew, that I am not a philosopher, a scientist or a doctor. I am not even a priest. However, whatever the legal answer to the question, “What is the law?”, we need to deal with the vexed and vexing question that surrounds the present law on assisted dying. It needs to be put into shape by Parliament. That, as I said a moment ago, is our duty. It is a duty from which we must not shrink.
The present state of affairs is increasingly under attack, but no statutory answer to the problem has been found. We reopened the debate today, but we have not concluded it—and I do not suppose that the Minister will do so. However, from my party’s point of view it is a question with which we shall have to come to grips, if not today then over the next few years. It cannot be allowed to rumble on in this unsatisfactory way.
I congratulate the hon. Member for Oxford, West and Abingdon (Dr. Harris) on securing this debate. The subject has clearly aroused enormous interest, and we have had an excellent debate—short but good.
We heard contributions from all sides; the arguments were well thought through and passionately stated, and the strongly held beliefs expressed were frequently based on personal experience and personal philosophy rather than party politics. Consequently, the three Liberal Democrat Members here today reflect three different positions. We have heard the Liberal Democrat Front- Bench spokesman, the hon. Member for Southport (Dr. Pugh), repudiating his own policy. We have seen the hon. Member for Cities of London and Westminster (Mr. Field) flanked by people who passionately disagree with everything that he said. Similarly, different views have been expressed by my right hon. and hon. Friends.
This debate is clearly not one that we needed to start. It is ongoing. Others with an interest—including Dignity in Dying, or the Voluntary Euthanasia Society—continue to press on the subject. Although Parliament has not changed its settled view since 1961, as the hon. and learned Member for Harborough (Mr. Garnier) made clear the debate has not been in suspended animation. I have no doubt that it will continue.
I wish to make it clear that I agree very much with what hon. Members said about the state of the current law. There is no doubt that the position is clear. As the hon. and learned Gentleman said, until the Suicide Act 1961 was passed, one could be sent to prison for attempting suicide if one managed to survive the attempt, and frequently people were imprisoned for such offences. Section 2 of that Act deals with the highly unusual offences of aiding, abetting, counselling or procuring the suicide or attempted suicide of another. It is not unique, but it is unusual because it criminalises something that is not itself an offence. There is a similar offence under the Female Genital Mutilation Act 2003, but the provision is highly unusual.
The crime of complicity in suicide—it is still a crime—covers a variety of situations. As we heard today, it covers situations of widely different moral culpability. There is a continuum, but Members would draw the line at different places. One merit of having a clear law is that it draws a clear line. However, as the hon. and learned Gentleman and others have said, one must then consider how to enforce it. If one has a clear line and no enforcement, is the position any clearer? That question has been the nub of our debate.
In the context of concerns expressed by my hon. Friend the Member for Bridgend (Mrs. Moon) in her brief intervention about technological advances and the use of the internet to encourage suicide, the Government have reviewed the situation. We have considered the current state of the law, as has the Law Commission. Among other things, the commission said that it believes the current law to be about right.
Having reviewed the matter, the Government, too, believe that the present law covers encouraging suicide on the internet. However, because equivalent provisions have been replaced in the rest of the criminal law, we believe that there would be benefits in updating and clarifying the language. We have said that we intend to do that when parliamentary time allows. I cannot say this morning, before the Queen’s Speech, when that might be—whether it will be sooner or later—but we have made it clear that we intend to simplify and modernise the language of existing offences. It will be done when parliamentary time allows.
The Minister says when “parliamentary time allows”, but on behalf of all who have taken part in this debate—I presume that we all want this debate to continue—may I ask her to ask the Leader of the House to give us the opportunity to debate the matter properly, on the Floor of the House in Government time?
It is not a no. It is not fair to say that. I have undertaken to draw the matter to my right hon. and learned Friend’s attention. No doubt, the hon. Gentleman will also do so.
It is clear from today’s debate that there are passionately held but differing views between parties. People can often be divided into those who have seen death closely—frequently the death of a loved one, and a number of Members have referred to their own experience in that respect; I, too, have had such an experience—and those who have not. That is one factor that may cause people to come to a conclusion on the subject. The experience of Mrs. Winifred Crew was prayed in aid by the hon. Member for Oxford, West and Abingdon. She is a constituent of mine, and I have discussed the matter with her. Others come to a view and face up to the concerns and difficulties of this aspect of the law through constituents who have faced such issues, even if we ourselves have not.
The debate was good partly because it was non-party political. It proceeded from our experiences and those of our constituents. It will continue to do so. It is difficult to be clear what the law should be—if one accepts that it should change—and what safeguards we should have. The debate was clearly between what I might call the slippery slope argument and the safeguards argument. One person’s slippery slope can be another person’s safeguard. Some take the view that the difficulties are so great that the capacity to draw a line somewhere in this new grey area, if we are to step over the current line, is such that it is not possible to change. That is the debate that is needed.
Does the Minister agree with the hon. Member for New Forest, East (Dr. Lewis) that no safeguard could ever work, and that even if we wanted to change the law—I am not saying that she should tell us her view—we should not go there because no safeguards could protect the vulnerable? If she does agree with the hon. Gentleman, does she accept that we have a crisis now? Vulnerable people could, for the reasons he gave, refuse treatment even when they were not terminally ill and thereby bring about their death, because they had been coerced directly or felt that they were being coerced? Does she agree with him?
I agree that there are pros and cons to the status quo, and I can see that there will be pros and cons to any change, or to the line being drawn in any particular place that might be suggested. We need a consensus in society and in Parliament before any change can be made—if, indeed, there is an acceptance among Members of Parliament that the law ought to be changed. The moral dilemmas and difficulties are great. We all have different views, as do the political parties, on precisely where that line should be drawn.
This morning’s debate has indicated that this is a live issue and a matter that parliamentarians and Governments must and will continue to consider. I have no doubt that there will be opportunities for those on all sides of the argument to debate the subject and to propose measures to change the law in one way or another. We will have the opportunity to take those decisions.